A recent trial in people with hypertension found that self-monitoring of blood pressure (BP) together with self-titration of antihypertensive medication resulted in better BP control compared with standard care.
This strategy has now been tested in high-risk patients, who have the most to gain from optimised BP control. Richard McManus from the University of Oxford and his team undertook TASMIN-SR, a randomised trial involving 552 patients with hypertension and at least one other high-risk condition, published in JAMA (online, 27 August 2014)
After 12 months, BP had fallen significantly in patients who self-managed according to a prespecified algorithm, without an increase in adverse events.
“Patients at high risk of cardiovascular disease whose BP is not optimally controlled could be considered for self-management,” the researchers conclude.
 McManus RJ et al. Effect of Self-monitoring and Medication Self-titration on Systolic Blood Pressure in Hypertensive Patients at High Risk of Cardiovascular Disease: The TASMIN-SR Randomized Clinical Trial. JAMA 2014;312(8): 799–808.